AIS News

AIS and BCJ Announce "Go-Live" Date for PAS

April 17, 2001

After three months of testing the Provider Access System (PAS) in various healthcare environments in Jamaica, AIS and BCJ have announced that Pilot testing of their new product has been successfully completed for Blue Cross of Jamaica's Medical, Optical, Dental and Pharmacy Provider Groups. Live electronic claims processing is set to begin on April 17, 2001.

PAS Pilot Testing Begins

January 5, 2001

AIS and BCJ announced today that Pilot Testing of the Provider Access System (PAS) is set to begin later this week. PAS was developed as a joint venture between local technology company Advanced Integrated Systems, and their foreign technology partners ProHealth Inc. PAS has been in development for the past 3 years, and AIS and BCJ are reported to have spent in excess of $3,000,000US on the product. The Pilot phase of the implementation process will involve the installation of PAS at several pre-selected pharmacies, medical, dental and optical offices in various geographically dispersed locations across the island. These Provides will use the new system for approximately 3 months, until such time as BCJ is satisfied that it yields accurate health claims adjudication results. Upon conclusion of the Pilot phase, all BCJ Providers will be able to sign on and use the system.

AIS Rolls Out High-Tech Health Insurance Product

February 28, 2000

Sunday, February 27, 2000 was a historic day at the Jamaica Pharmaceutical Society’s quarterly meeting at Mandeville Hotel, when Advanced Integrated Systems (AIS) rolled out its new online health insurance claims adjudication system called PAS – short for Provider Access System.

Blue Cross of Jamaica will be the first to employ PAS for claims’ adjudication and approval with healthcare providers, and was present for its demonstration in Mandeville.

AIS’ Chief Executive Officer, Douglas Halsall and his team, stated that PAS represented a multi-million US dollar joint-venture between AIS, Prospective Health, Inc. (PHI) of Chicago and venture-capitalist HAS, and is intended for the international marketplace with Blue Cross of Jamaica being the first to enjoy the feature-rich environment of this powerful tool. AIS’ technology partner – Prospective Health, Inc. (PHI), lists among its customer base, US insurance giants such as Aetna and Anthem Blue Cross Blue Shield.

The ‘internationalisation’ of the product – which is the objective of the joint venture, is partially financed by HAS, and has taken place effectively over the past eighteen months leading to its deployment at this writing. This means that one health insurance policy can cover any combination of health benefits or service types, using its online claim approval feature at any participating healthcare provider. The provider - whether doctor, dentist, optician, lab, hospital or pharmacy, merely enters the relevant procedure or drug code through the AIS-developed, Windows-based interface and swipe the subscriber’s card just like a credit or debit card. Within seconds, the claim is either accepted or rejected with a detailed explanation for the subscriber’s/provider’s knowledge. Accepted claims are paid within seven days, thus increasing the attractiveness of PAS to providers. Rejected claims are identified immediately and consequently, are no longer a liability to the healthcare provider. If the subscriber is not in agreement with the reason given for the rejection s/he can refer to a helpdesk at the insurance company where this concern can be aired. The helpdesk will immediately investigate the subscriber’s queries or concerns and provide the most suitable and immediate response or remedy.

The system is also capable of monitoring and managing benefit limits and subscriber characteristics in order to reduce health card abuse.

PAS will provide pharmacists with automatic drug interaction checks and a frequently updated database of prescription and over-the-counter drugs that are approved for use in Jamaica. This is maintained alongside a database of all doctors and dentists (prescribers) in order to curb any improper prescribing or dispensing practices. The drug database can also display generic drug substitutes to facilitate appropriate prescribers’, providers’ or customers’ requirements. PAS can also produce prescription instruction labels and information leaflets, thus affording pharmacists more time for counseling with their patients.

Mr. Halsall is firm in his resolve to make health-insurance transaction processing as efficient as cash transactions, and long waiting periods at the pharmacy - a thing of the past with PAS. Further - he states, the patient profile database maintained by the provider, will be automatically and accurately updated as a bi-product of the patient-invoicing process. This will ensure accurate record keeping, thereby enhancing the entire patient/doctor/pharmacist relationship.

PHI’s Project Manager – Brian Pavlik, commended the high level of competence experienced in their relation with their Jamaican partners and states that this augurs well for the international success of the product. “The outcome so far of this project, has more than vindicated our decision to particpate”, he says. “We see this as a solution that reflects true vision in the health care industry. It surely classifies it as being a product of the ‘new economy’ - Jamaicans can be proud of the contribution of Advanced Integrated Systems to this venture”. PAS also provides a technology link with the US, in respect of claims processing. This means that if US health insurance companies were to be encouraged to appoint Jamaican providers, Americans could tender their US health cards here.